Employment Type:

Shift:

Description:

Claims Processing Tech II – 60 Cohoes Ave- Green Island

Northeast Home Medical Equipment is looking for a part time Claims Representative. This position has flexible hours weekdays while kids are in school. Join a dynamic team who work with patients, families, physicians and insurance companies. The position requires creative problem solving and would be investigating claim denials and working to improve accounts receivable .

Position Highlights:

• Quality of Life: Where career opportunities and quality of life converge
• Advancement: Strong orientation program, generous tuition allowance and career development
• Work/Life: Positions and shifts to accommodate all schedules

Responsibilities:

• Generates weekly AR reports to monitor status of all outstanding denials and held billing.
• Monitors and obtains reauthorization needed for ongoing rentals.
• Responsible to investigate and resolve accounts being held for additional information that is needed from the patient, and or physician.
• Responsible for working denials, including those related to change in insurance to obtain current insurance information, verify coverage criteria by product and obtain needed documentation to insure ongoing payment and prevent timely filing denials.
• Responsible to resolve open held billing by working closely and collaboratively with billing service to investigate and address .
• Works closely with Patient Accounts Manager and Customer Service Supervisor to prioritize denials by timely, hold reason, and dollar amount.
• Utilizes electronic workflow, electronic patient records and billing software to research, identify, resolve and communicate status of work.
• Communicates with patient, management and payer to obtain all needed reauthorizations as well as needed medical justification.
• Communicate to patients in writing status of changes in financial coverage and initiate termination of service based on individual situations.
• Measures and reports AR by reason and communicate out to management staff weekly

What you will need:

• Detail oriented,
• Have the ability to multi-task
• Previous experience in banking, collections or a busy call center is a must.
• Previous health care experience is a plus.

• Associates degree preferred but not required; High school diploma required.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.